Pitrelli N, Basti M, Nardi M, Marrone A, Vacca M, D'Amico G
Divisione di Chirurgia Generale, Ospedale S. Massimo, Penne, Pescara.
Minerva Chir. 1995 Jan-Feb;50(1-2):155-7.
The authors describe a case of giant vesical calculus in an 89 year old patient. The diagnosis, as in the other cases reported in the international literature, was made after a series of laboratory and instrumental exams, for groups reported by the patient in the lower abdomen. Operated for the removal of the vesical calculus, he was considered healed after a fortnight. The vesical calculus has a mixed composition and it weighs about 380 grams. The revision of the literature shows the various chemical composition of the vesical calculus that does not permit to identify a common aetiology. It is not possible to demonstrate if the formation of this kind of calculus is primary (in the urinary bladder) or if it is proper of the high urinary tract or mixed. The most recurrent causes being various and different confirm the mixed aetiopathologic theory. The diagnosis, often casual, is made thanks to the most common diagnostic exams; as it is difficult to make a complete cystoscopic control because the bladder is almost completely occupied by the lithiasic formation. The surgical therapy consists of a epicystotomy with a following removal of the calculus. In literature, moreover, cases treated with extra-body lithotripsy are not reported, on the contrary ot happens daily for the lithiasis of the high urinary tract.
作者描述了一例89岁患者的巨大膀胱结石病例。与国际文献中报道的其他病例一样，诊断是在进行了一系列实验室和器械检查后做出的，这些检查是针对患者下腹部出现的症状。患者接受了膀胱结石摘除手术，两周后被认为已治愈。膀胱结石成分混合，重约380克。文献回顾显示膀胱结石的化学成分各异，无法确定其共同病因。无法证明这种结石的形成是原发性的（在膀胱内），还是源于上尿路或两者皆有。最常见的病因多种多样，这证实了混合病因病理学说。诊断通常是偶然做出的，借助于最常见的诊断检查；由于膀胱几乎完全被结石占据，很难进行完整的膀胱镜检查。手术治疗包括膀胱切开术及随后的结石摘除。此外，文献中未报道过采用体外碎石术治疗的病例，相反，上尿路结石每天都在采用这种方法治疗。
